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HomeMy WebLinkAbout04. Approve Agrmt w-Sacramento Metro Fire Dist-GEMT Programr FROM: OFFICE OF , BY: JAY IBEY, ASSISTANT FIRE CHIEFp D2018 GROUND"i' i ADMINISTRATIVE AGREEMENT TECOMMENDATION That the City Council authorize the City Manager to execute the agreement with Sacramento Metropolitan Fire District for administrative cost recovery through the GEMT program. California Welfare and Institutions Code§14105.94, enacted October 2, 2011, authorized the Ground Emergency Medical Transportation Services (GEMT) supplemental reimbursement program. This voluntary certified public expenditure based program provides additional funding to eligible governmental entities that provide GEMT services to Medi -Cal beneficiaries. The Centers for Medicare and Medicaid Services approved State Plan Amendment 09-024 on September 4, 2013, authorizing the federal share of the supplemental reimbursement payments based on uncompensated costs for Medi -Cal fee-for-service transports. The California Department of Health Services (DHCS) has determined that public agencies providing advanced life support (ALS) and basic life support (BLS) transports are eligible for increased reimbursements for pre -hospital care transports. Sacramento Metro Fire Department has been designated as the administrator for the state's GEMT cost recovery program. GEMT participating agencies are required by the DHCS to have an annual administrative cost recovery agreement in place with Sacramento Metro Fire District. Since the GEMT program has been established, Downey Fire Department has maintained similar agreements with Sacramento Metro Fire District. FISCAL IMPACT Our previous GEMT agreements cover 6 fiscal years and have generated a total of approximately $870,000 in reimbursements. Staff time (Finance and Fire Departments) of approximately forty (40) hours combined is required to prepare the cost recovery reports. TITLE GROUND AMBULANCE MEDICAL TRANSPORTATION ADMINISTRATIVE AGREEMENT DATE MAY 7, 2017 PAGE# 2 ATTACHMENTS Attachment A Agreement For Recovery of Administrative Costs for Implementation and Recovery of Ground Emergency Medical Transportation Payments. Attachment B Agreement with the California Department of Health Care Services for Administrative Services Related to Medi -Cal Ground Emergency Medical Transportation Services Supplemental Reimbursement Program. 19 AGREEMENT FOR RECOVERY OF ADMINISTRATIVE COSTS FOR IMPLEMENTATION AND RECOVERY OF GROUND EMERGENCY MEDICAL TRANSPORTATION PAYMENTS This agreement is made and entered into on this day of _ 20 - between the Sacramento Metropolitan Fire District, ("Metro Fire") a political subdivision of the State of California and, City of Downey Fire Department, ("GEMT Transporter"). WHEREAS, the State Department of Health Care Services ("State") has developed and is administering the Medi -Cal Ground Emergency Transportation Supplemental Reimbursement Program pursuant to the California Welfare and Institutions Code Section 14105.94 ("State Code") and State Plan Amendments ("SPA") 09-024; and, WHEREAS, the State has entered into an agreement with Metro Fire for administrative services related to the Medi -Cal Ground Emergency Transportation Supplemental Reimbursement Program pursuant to the State Code and SPA 09-024 ("State Agreement"), which is attached hereto as Exhibit A, and is incorporated as if set forth fully herein; and, WHEREAS under the State Code an eligible provider of ground emergency medical transportation services may be entitled to supplemental Medi -Cal reimbursement as set forth in those provisions; and, WHEREAS an eligible provider as described in State Code is required to enter into an agreement to reimburse the State for implementing and administering the Supplemental Reimbursement Program as a condition of receiving supplemental reimbursement pursuant to the State Code; and, WHEREAS pursuant to the State Agreement, Metro Fire has been designated by the State to recover the administrative and implementation costs required to be paid by eligible providers under the State Code; and, WHEREAS Metro Fire will incur administrative and other costs in connection with billing GEMT Transporter for costs, and has assumed the risk of payment, or non- payment of the costs from GEMT Transporter; NOW therefore the Parties enter into this Agreement for the purpose of setting forth the manner and terms for payment of administrative costs by the eligible GEMT providers to Metro Fire, under the following terms and conditions. Page 1 of 6 Attachment "A Metro Fire is a designated agency for the collection of costs related to the GEMT Supplemental Medi -Cal Reimbursement Program. GEMT Transporter is an eligible provider of GEMT services as described in the State Code. This Agreement shall be effective and commence as of July 1, 2017 and shall end on June 30, 2020. However, GEMT transporter acknowledges and agrees that cost reports submitted by GEMT Transporters are subject to audit by the State of California for a period of thirty-six (36) months from the date of submission of the reports by the GEMT Transporter to the State of California. During that period of time, State administrative costs as defined in the State Code will continue to be incurred by the State for which the GEMT Transporter agrees to pay to Metro Fire pursuant to Section IV below. The GEMT Transporter agrees to pay its transporter share of administrative costs pursuant to Section V. after the termination of this Agreement, whetherthisAgreement is terminated by its term, or in the event GEMT Transporter elects to terminate the Agreement, or in the event that Metro Fire terminates the Agreement. Where there has been a need for Metro Fire to provide services essential to the GEMT program in the State of California and where such services have been provided prior to the date of execution of this Agreement, both Parties agree that the calculation, and payment, of services under this Agreement shall begin on July 1, 2017. Metro Fire will provide the following services: A. Advance of GEMT administration costs to the State as provided by SPA 09-024 on behalf of the GEMT Transporter. B. Assistance to the State GEMT program on behalf of the GEMT Transporters including: a. Cost Report development b. Information resource to the State and Federal governments c. Program development to expand the scope of eligible costs C. Assistance to the GEMT Transporter including: a. General (offsite) program assistance b. Ombudsman services when needed c. Advocate for reimbursements d. Governmentrelations Page 2 of 6 The GEMT Transporter will provide the following services: A. Accurate reports of transports eligible under the GEMT program B. Accurate record-keeping and retention of records for a period of not less than seven (7) years C. Provide all records upon request for audit purposes GEMT Transporter agrees to pay Metro Fire the transporter's share of the State administrative costs as defined in the State Code. The GEMT transporter share will be based upon the administrative costs per fee for service Medi -Cal transport, multiplied by the GEMT Transporter's number of fee for service Medi -Cal transports for each reporting period. The administrative costs per fee for service Medi -Cal transport will be determined by the State of California based on the total administrative costs of the State in administering the GROUND EMERGENCY MEDICAL TRANSPORTATION SERVICES SUPPLEMENTAL REIMBURSEMENT PROGRAM divided by the total number of fee for service Medi -Cal transports statewide by all participating transporter agencies for each reporting period. In addition, the GEMT transporter will compensate Metro Fire one percent (1 %) of the _GEMT transporter's gross State Supplemental Reimbursement of GEMT services under the State Code for each reporting period for Metro Fire's program services, administrative services, expansion of program for future reimbursements, contracting services, other expenses, cost of advancing funds for the State,_ and the risk of non-payment from GEMT Transporters. A. Metro Fire will notify, via email, the amount due under Section V. of this Agreement by the GEMT Transporter once theamountis determined. B. All amounts due under this Agreement will be paid to Metro Fire no later than 30 days after the first notification is sent to the GEMT Transporter via one of the following methods: ACH/EFT, warrant from Invoice, or Credit Card C. Non-payment by the GEMT Transporter constitutes a breach of this Agreement and, if not cured, will result in a termination of this Agreement pursuant to Section XII below. 1. A breach of this Agreement may be cured by the successful completion of the payment transaction to Metro Fire by GEMT Transporter within 30 days' notice by Metro Fire. 2. The State will not provide GEMT supplemental reimbursements to the GEMT Transporter without a valid Agreement for Recovery of Administrative Costs for Implementation and Recovery of GEMT Payments with Metro Fire. Page 3 of 6 T - The GEMT Transporter acknowledges and agrees that the compensation paid to Metro Fire pursuant to this Agreement is intended to cover the costs for administering the supplemental reimbursement program under Section 14105.94(4) of the State Code. The compensation payable to Metro Fire is approved by the State, pursuant to the State Agreement attached as Exhibit A. The GEMT Transporter hereby agrees to waive any claim, action, or challenge to the payment method for the collection of costs under Section 14105.94(d) of the State Code, in the manner set forth in this Agreement. VII. DISPUTE RESOLUTION In the event of a dispute between the Parties in the terms of this Agreement as to any issue arising under this Agreement, the Parties agree to meet and negotiate in good faith to resolve such dispute. This shall not limit the Parties' right to pursue any available remedies at law or in equity. It is agreed that the GEMT Transporter shall defend, hold harmless and indemnify Metro Fire, its officers, employees, and agents from any and all claims liability, loss or expense (including reasonable attorney fees) for injuries or damage to any person and/or any property which arise out of the terms and conditions of this Agreement and the negligent or intentional acts or omissions of the GEMT Transporter and its officers, employees or agents. It is further agreed that Metro Fire shall defend, hold harmless and indemnify the GEMTTransporter and its officers, employees, and agents from any and all claims liability, loss or expense (including reasonable attorney fees) for injuries or damage to any person and/or any property which arise out of the terms and conditions of this Agreement and the negligent or intentional acts or omissions of Metro Fire, its officers, employees, or agents. If any term, condition, or provision of this Agreement is held by a court of competent jurisdiction to be invalid, void, or unenforceable, the remaining provisions will nevertheless continue in full force and effect, and shall not be affected, impaired or invalidated in any way. Notwithstanding the previous sentence, if a decision by a court of competent jurisdiction invalidates, voids, or renders unenforceable, a term, condition,or provision in this Agreement that is included in the purpose of this Agreementthenthe Parties to this Agreement shall either amend this Agreement pursuant to Section X. Or it shall be terminated. Page 4 of 6 a Ji 121 L, I W -,l Except as provided herein, no alteration, amendment, variation, or waiver of the terms of this Agreement shall be valid unless made in writing and signed by both Parties. Waiver by either party of any default, breach or condition precedent shall not be construed as a waiver of any other default, breach or condition precedent, or any other right hereunder. XI. INTERPRETATION This Agreement shall be deemed to have been prepared equally by both of the Parties, and the Agreement and its individual provisions shall not be construed or interpreted more favorably for one party on the basis that the other party prepared it. Either of the Parties may terminate this Agreement upon thirty (30) days written notice to the other party. Notice shall be deemed served on the date of mailing. GEMT Transporter's responsibility for administrative costs incurred by the State associated with transporter costs reports and/or the State's audit of those costs shall survive the termination of the Agreement. r Z4101zV-1Xl W4 This Agreement constitutes the entire Agreement between Metro Fire and GEMT Transporter regarding the subject matter of this Agreement. Any prior agreements, whether oral or written, between Metro Fire and GEMT Transporter regarding the subject matter of this Agreement are hereby terminated effective immediately upon full execution of this Agreement. XIV. INTEGRATION CLAUSE This Agreement and any exhibits attached hereto shall constitute the entire Agreement among the Parties to it and supersedes any prior or contemporaneous understanding or agreement with respect to the services contemplated, and may be amended only by a written amendment executed by both Parties to this Agreement. Page 5 of 6 The validity of this Agreement and its terms or provisions, as well as the rights and duties of the Parties hereunder, the interpretation and performance of this Agreement shall be governed by the laws of the State of California. SACRAMENTO METROPOLITAN FIRE DISTRICT Signature: Amanda Thomas, Chief Financial Officer Date Signature. Date Name: Title: Page 6 of 6 NO-MIMI The parties to this Agreement are the Sacramento Metropolitan Fire District (SMFD)1 in Its capacity as the host entity, and the California Department of Health Care Services (DHCS). MUMU DS is the single state agency responsible for administering the California Medical Assistance Program (Medi—Cal) pursuant to California Welfare and Institutions Code section 14100.1. 2. Term of the Agreement. I 1, 2017, through and including, June 30, 2020. 3. Maxir-num Pavable Amount. in full consideration of DHCS' performance of the services described in Schedule A an the conditions in Section 6., the amount that SMFD shall be obligated to pay for services rendered for the term of this Agreement shall not exceed $700,000 each State Fiscal Year (SFY) beginning SFY 2017-18. The State Fiscal Year begins on July 1 st each year and ends on June 30th. 11 Z I I I IfiflIlli !III The purpose of this Agreement is for DHCS to perform the administrative services related to administering the GEMT supplemental reimbursement program as described in Schedule A, attached hereto and incorporated by reference herein. Further, the purpose of this agreement is to designate SMFD as the host entity that will collect administrative costs, as defined in Welfare and Institutions Code section 14105.94, subdivision (d), pursuant to written contracts between SMFD and eligible providers. The eligible providers P-1 Provi W i� lia r Agreement between the eligible providers and DHCS requires, the eligible providers satisfy their responsibilities for reimbursing DHCS for its administrative Cos S '6 cndpapppaprograd p itioning their rticipation in the sulemental yment m an•their receit w � I oN- 1 SMFD and the eligible providers for the payment of DHCS' administrative costs, t subject of this Agreement. It is understood by both SMFD and DHCS that payments s forth under this Agreement are for the purpose of reimbursing DHCS for all direct anis indirect expenses related to performing these activities. Any notice, request, demand or other communication required or permitted hereunder, shall be deemed to be properly given when deposited in the United States mail, postage prepaid, and addressed: M GEMT Coordinator Sacramento Metropolitan Fire District Attn: Chief Financial Officer 10545 Armstrong Avenue, Suite 200 Mather, CA 95655 Or to such person or address as SMFD may, from time to time, furnish in Writing to DHCS. lei California Department of Health Care Services Safety Net Financing Division Attn: ShielaMendiola, Medi -Cal Supplemental Payment Section 1501 Capitol Avenue, MS 4504 P.O. Box 997436 Sacramento, CA 95899-7436 6. Payment Terms and Invoicindl A. SMFD shall compensate DHCS for services listed in Schedule A� as authorze y Section 7 of this agreementi within forty-five (45) days of receipt of an invoice from DHCS, which specifies both the total federally claimable administrative cost and the nonfederal share of the tot,,44.Q�g& B. Failure by SMFD to timely compensate DHCS pursuant to paragraph A shall constitute a material breach of this Agreement by SMFD, which at DHCS' discretion ' may result in termination by DHCS pursuant to Section 9. SMFD may cure such breach by rendering payment of the amount owed to DHCS prior to the termination of this Agreement pursuant to Section 9, at which point such notice of termination shall be automatically rescinded. WFIMUM, no event shall payment be made by SMFD for any invoice or portion thereof exceeding the Agreement amount specified in Section 3. Payment for any services rendered by DHCS exceeding the Agreement amount shall require an amendment to this Agreement pursuant to Section 8. Services rendered by DHCS shall cease until an amendment is executed. D, DHCS shall submit annual invoices to SMFD no sooner than forty-five (45) days following the close of each SFY. DHCS'invoice shall include the supplemental form identifying the following summarized categories of costs for the period billed: salary, benefits, operating expenses, and total costs. E SMFD shall not be obligated to pay DHCS for the administrative services covered by any invoice if DHCS presents the invoice to SMFD more than one (1) year after this Agreement terminates. California Department of Health Care Services Safety Net Financing Division Attn: Medi -Cal Supplemental Payment Section 1501 Capitol Avenue, MS 4504 P.O. Box 997436 Sacramento, CA 95899-7436 7. o op 6f W&k � In consideration of the payments hereinafter set forth, DHCS shall perform the activities related to administering the GEMT supplemental reimbursement program as described in Schedule A, attached hereto and incorporated by reference herein. It is understood by both SMFD and DHCS that payments set forth under this Agreement are for the purpose of reimbursing DHCS for all direct and indirect expenses related to performing these activities. Should the scope of work or services to be performed under this Agreement conflict with DHCS' responsibilities as the single agency for Medicaid in California (Medi - Cal), the single state agency responsibilities shall take precedence. DHCS' cessation of any activities due to single state agency responsibilities does not relinquish the obligation of SFMD to reimburse DHCS for administrative costs actually incurred by DHCS. 8. Amendments. Amendments to this Agreement shall be made only by a written agreement signed by the parties to this Agreement, and if required by State law, by approval of the California De,gartment of General Services. Notwithstanding the orevious sentence updates on who will serve as the contact person identified in Section 5 may be transmitted by email to the other contact person or persons. In conformance with state law requiring SMFD to pay the State for the nonfederal share of its federally reimbursable administrative costs in administering the GEMT supplemental reimbursement program, by entering into this Agreement, SMFD acknowled-ves and acc . ts that this ?mended to reflect updates to the State's administrative costs. 9. Termination, This Agreement may be terminated by any party upon Written notice given at least thirty (30) calendar days prior to the termination date. Notice shall be addressed to the respective parties as identified in Section 5 of this Agreement. SMFD shall be obligated to it for all of the administrative costs incurred from the services duly performed by DHCS until t.k-4e-iTnri4Tafkxt 10- L , The terms of Section 6 (Payment Terms and Invoicing), the last sentence of Section 9 (termination)� Section 1 OA (Indemnification), and Section 1 OC (Records) shall survive the termination of this Agreement. 10. General Provisions, A. Indemhification. It is agreed that SMFD shall defend� hold harmless, an in emnify DHCS, its officers, employees, and agents from any and all claims, liability, loss or expense (including reasonable attorney fees) for injuries or damage to any person and/or any property which arise out of the terms and conditions of this Agreement and the negligent or intentional acts or omissions of SMFD, its officersi employees, or agents. & Sevot&&. If any term, condition, or provision of this Agreement is held by a court of competent jurisdiction to be invalid, void, or unenforceable, the remaining provisions will nevertheless continue in full force and effect, and shall not be affected, impaired or invalidated in any way. Notwithstanding the previous sentence, if a decision by a court of competent jurisdiction invalidates� voids, or renders unenforceable a term, condition, or provision in this Agreement that is included in the purpose of this Agreement then the parties to this Agreement shall either amend this Agreement pursuant to Section 8, or it shall be terminated. 1) Upon written notice, DHCS agrees to provide to SMFD, or any federal or State department having monitoring or reviewing authority, access to and the right to examine and audit its applicable records and documents for compliance with relevant federal and State statutes, rules and regulations, and this Agreement. 2) DHCS shall maintain and preserve all records relating to this Agreement f] a period of three (3) years from receipt of the last payment of feder financial participation (FFP) or until audit findings are resolved, whichev is greater. DCOM610M8 With A ifidabl6tOW8. All services to be performed by DHCS pursuant to this Agreement shall be performed in accordance with all applicable federal and State laws, including, but not limited to: Emu= r py,qjM- _ 5) Government Code § 53060-, 6) The California Medicaid State Plan; 7) Laws and regulations including, but not limited to licensure, certification, confidentiality of records, quality assurance, and nondiscrimination. 7. Cbht�qlfib law. The validity of this Agreement an its terms or provisions as well as the rights and duties of the parties hereunder, the interpretation and performance of this Agreement shall be governed by the laws of the State of California. F� Intgotati6n Clause� Notwithstanding the GEMT supplemental reimbursement program Provider Participation Agreement in Section G. listed below and the DHCS Form 6208 signed by SMFD, this Agreement and any exhibits attached hereto shall constitute the entire agreement among the parties to it and supersedes any prior or contemporaneous understanding or agreement with respect to the services contemplated. G. PibV1d4r Partibipgji6n: Abreem6tit. This Agreement does not alter, amend, or override any of the eligible provider's obligations and SMFD's obligations contained in the Provider Participation Agreement. The Provider Participation Agreement is an agreement between DHCS and each of the eligible providers, including SMFD in its capacity as an eligible provider. The Provider Participation Agreement provides the terms and conditions for the eligible providers to participate in the supplemental payment program. Such terms and conditions include, but are not limited to, (i) the requirement that the eligible providers reimburse SMFD for their share of the administrative costs incurred by DHCS in administering the supplemental payment program authorized in section 14105.94, subdivision (d), and (ii) the term that DHCS shall immediately and automatically without prior notice cease making supplemental payments and initiate a recovery effort against an eligible provider that fails to pay its administrative costs pursuant to the terms of the Provider Participation Agreement. H. Periodic Assessment. Pursuant to 1410 5.94, subdivision (d), SMFID enters into this Agreeme�t in order to implement the GEMT supplemental reimbursement program under which its eligible facilities may participate and for which SMFID will pay for the nonfederal share of all federally reimbursable administrative costs incurred by DHCS performing activities described in Section 7. SFMD agrees that DHCS may conduct a periodic assessment, as determined by DHCS, of such costs incurred by DHCS to determine compliance with Welfare and Institutions Code section 14105.94, subdivision (d), and further agrees that all invoicing as described in Section 6 and any other relevant documentation will be accordingly updated to ensure compliance with Welfare and Institutions Code section 14105.94, subdivision (d). 1. CohfdAgreement is entered in accordance with Welfare and Institutions Code section 14105.94, subdivision (d). Any provision of this Agreement in conflict with the present or future governing authorities of the Welfare and Institutions Code or of applicable state law or federal law and rules, including but not limited to, Title XIX of the Social Security Act, California's Medicaid State Plan, implementation directives promulgated by DHCS, and implementation directives promulgated by the Centers for Medicare & Medicaid Z�K Services, is hereby amended to conform to those authorities. Such amend provisions supersede any conflicting provision in this Agreement. I The persons signing this Agreement on behalf of SMFD and DHCS, as applicable, represent and warrant that he or she is an individual duly authorized and having authority to sign on behalf of, and approve for, SMFD or DHCS, as applicable, and is authorized and designated to enter into and approve this Agreement on behalf of SMFD or DHCS, as applicable. SACRAMENTO METROP ITAN FIRE DISTRICT 1-17 r Signature: Name: Todd Harms Title: Fire Chief Date: 0 SACRAMENTO M ET POLITAN FIRE DISTRICT Signature: Name: Amanda Thomas Title: Chief Financial Officer Date - CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES Contract Management Unit Signature: Name: Title: C;ontwt Management Unit Date: CALIFORNIA DEPARTMENT OF GENERAL SERVICEI Office of Legal Services 6"r P -W3. Name: Title: Date: mffl• i, rej R KI 110 01 t In, C1 SCHEDULE A SIZA&F—Mad IiAklm cAuFoRw DEPARTMENT OF HEALTH CARE SERVICES JULY 1, 2017 - JUNE 30, 2020 A. Lead the development, imp ementat on, an• .• ministration for the Medi -Cal Ground Emergency Medical Transportation Services (GEMT) supplemental reimbursement program and ensure compliance with provision set forth in SPA 09-024i B. Submit claims for federal financial participation (FFP) based on expen itures or GEMT services that are allowable expenditures under federal law. C. On an annual basis, submit any necessary materials to the federal government to provide assurances that claims for FFP will include only those expenditures that are allowable under federal law. D. Reconcile certified public expenditure (CPE) invoices with supp ementa reimbursement payments and ensure that the total Medi -Cal reimbursement provided to eligible GEMT providers will not exceed applicable federal upper payment limit as described in 42 C.F.R. 447 -Payments For Services. E. Complete the audit and settlement process of the interim reconciliations for the claiming period within three years of the postmark date of the cost report and conduct on-site audits as necessary. F. Calculate the actual costs for administrative accounting, policy development, and data processing maintenance activities, including the indirect costs related to the GEMT supplemental reimbursement program provided by its staff based upon a cost accounting system which is in accordance with the provisions of Office of Management and Budget Circular A-87 and 45 Code of Federal Regulations Parts 74 and 95. G. Maintain accounting records to a level of detail Which identifies the actual expenditures incurred for personnel services which includes salary/wages, benefits, travel and overhead costs for DHCS' staff, as well as equipment and all related operating expenses applicable to these positions to include, but not limited to, general expense, rent and supplies, and travel cost for identified staff and managerial staff working specifically on activities or assignments directly related to the GEMT supplemental reimbursement program. Accounting records shall include continuous time logs for identified staff that record time spent in the following areas: the GEMT supplemental reimbursement program, general administration. K Ensure that an appropriate audit trail exists within DHCS records and accounting system and maintain expenditure data as indicated in this Agreement. MMEM 1. Designate a person to act as liaison with SMFD in regard to issues concerning this Agreement. This person shall be identified to SMFD's contact person for this Agreement, J, Provide a written response • email or mail to SMFD's contact person within thirty (30) days of receiving a written request for information related to the GEMT supI lemental reimbursement program. K. Provide accounting, and program technical assistance, and training related to the GEMT supplemental reimbursement program to SMFD personnel after receiving a written request from SMFD contact person. 11 &T,71111 so an tZaKSOY-ANXII 101SUFT-T.-T Awl 1 � . parties to thiares AgreementSacramento Metropolitan Fire its capacity as host entity, and the CaliforniaDepartment of As authorized by California Welfare and Institutions Code section 14105.94, SMFD acts as administrative agency forthe Medi -Cal GroundMedi-CaEmergency Medical •• . • Services (GEMT) Supplemental Reimbursement Program on behalf of all publicly owned and operated GEMT providers in California participating in the program, DHCS is the single state agency responsible for administering the California Medical Assistance Program pursuant toCalifornia. . • • Code . section ii Z Term of the Agr emeht Subject to the provisions of this Agreement, the term of this Agreement shall be from July 1, 2017, through and including, June 30, 2020, 3. Maximum Pavable Amount. In full consideration of DHCS' performance of the services described in Schedule A ans the conditions in Section• amount that. be obligated to pay for` ` rendered for the term of this Agreement shall not exceed $700,000 each State Fiscal Ye beginning SFY 2017-18.begins on f ends on ii ` it .i f. r` - • -I I IN i • ! ` `moi " ii iii f i • • .. r • • i i '. ii' i ii' • i i i r i • i i i• iiJams-MMOMMi" • i0 . ai • ` i i i • ' ` • �•,.`I • 1 • i` • -.r to administering the GEMT supplemental` • ` program as described in Schedule r e• hereto and incorporated by reference herein,Further,purpose of this agreement is to designate SMFD as the host entity that will collect administrative costs, as defined in Welfare and Institutions Code section 14105.94, subdivision (d), pursuant to written contracts between SMFD and eligible providers, The eligible providers are required to enter into written contracts by the Provider Participation Agreement, Which ;?.re enteredinto between the eligible providers and DHCS. The Provider Pa •. i Page 2 of 8 DHCS #16-93420 Agreement between the eligible providers and DHCS requires the eligible providers to satisfy their responsibilities for reimbursing DHCS for its administrative costs by conditioning their participation in the supplemental payment program and their receipt of such supplemental funds upon entering into the written reimbursement contracts between SMFD and the eligible providers for the payment of DHCS' administrative costs, the subject of this Agreement. It is understood by both SMFD and DHCS that payments set forth under this Agreement are for the purpose of reimbursing DHCS for all direct and indirect expenses related to performing these activities. 5Contact Persons. Any notice, request, demand or other communication required or permitted hereunder, shall be deemed to be properly given when deposited in the United States ii prepaid, and addressed: GEMT Coordinator Sacramento Metropolitan Fire District Attn: Chief Financial Officer 10545 Armstrong Avenue, Suite 200 Mather, CA 95655 California Department of Health Care Services Safety Net Financing Division Attn: Shiela Mendiola, Medi -Cal Supplemental Payment Section 1501 Capitol Avenue, MS 4504 P.O. Box 997436 Sacramento, CA 95899-7436 & Paymentlermg and Invoicing. A. SMFD shall compensate DHCS for services iste in c e u e A, as aut orize by Section 7 of this agreement, within forty-five (45) days of receipt of an invoice from DHCS, which specifies both the total federally claimable administrative cost and the nonfederal share of the total cost. Bi Failure by SMFD to timely compensate DHCS pursuant to paragraph A shall constitute a material breach of this Agreement by SMFD1 which at DHCS' discretion, may result in termination by DHCS pursuant to Section 9. SMFD may cure such breach by rendering payment of the amount owed to DHCS prior to the termination of this Agreement pursuant to Section 9, at which point such notice of termination shall be automatically rescinded, C. In no event shall payment be made by SMFD for any invoice or portion thereof exceeding the Agreement amount specified in Section 1 Payment for any services rendered by DHCS exceeding the Agreement amount shall require an amendment to this Agreement pursuant to Section 8. Services rendered by DHCS shall cease until an amendment is executed. DDHCS shall submit annual invoices to SIVIFD no sooner than forty-five (45) da following the close of each SFY. DHCS' invoice shall include the supplemental for r identifying the following summarized categories of costs for the period billed: Sala benefits, operating expenses, and total costs. E SMFD shall not be obligated to pay DHCS for the administrative services covere by any invoice if DHCS presents the invoice to SMFD more than one (1) year after this Agreement terminates. California Department of Health Care Services Safety Net Financing Division Attn: Medi -Cal Supplemental Payment Section 1501 Capitol Avenue, MS 4504 P.O. Box 997436 Sacramento, CA 95899-7436 in consi eration of the payments hereinafter set forth, DHCS shall perform the activities related to administering the,GEMT supplemental reimbursement program as described in Schedule A, attached hereto and incorporated by reference herein. It is understood by both SMFD and DHCS that payments set forth under this Agreement are for the purpose of reimbursing DHCS for all direct and indirect expenses related to performing these activities. Should the scope of work or services to be performed under this Agreement conflict with DHCS' responsibilities as the single agency for Medicaid in California (Medi - Cal), the single state agency responsibilities shall take precedence. DHCS' cessation of any activities due to single state agency responsibilities does not relinquish the obligation of SFMID to reimburse DHCS for administrative costs actually incurred by DHCS. & Amendments. T116-i-re'TrreT I'll IF-FT17711MM . T7d,-*.-6—'WTIfTPJ-.#Pj-cU-TTTIT L6TT-,AtTC-61`M5TR__5T�#,TF", . 1 parties to this Agreement, and if required by State law, by approval of the California Department of General Serviceotwithstanding the previous sentence, updates on who will serve as the contact person identified in Section 5 may be transmitted by email to the other contact person or persons. In conformance with state law requiring SMFD to pay the State for the nonfederal share of its federally reimbursable administrative costs in administering the GEMT supplemental reimbursement program, by entering into this Agreement, SMFD acknowledges and accepts that this Agreement shall be automatically amended to reflect updates to the State's administrative costs. This Agreement may be terminated by any it upon written notice given at east thi (30) calendar days prior to the termination date- Notice shall be addressed to th respective parties as identified in Section 5 of this Agreement. SMFD shall be obligate 'I to pay for all of the administrative costs incurred from the services duly perfolrmed b DHCS until the termination date. The terms of Section 6 (Payment Terms and Invoicing), the last sentence of Section 9 (termination), Section 1 GA (indemnification), and Section 1 OC (Records) shall survive the termination of this Agreement. 10. General Provisi.ons. A. it is agreed that SMFD shall defend, hold harmless, and indemnify DHCS, its officers, employees, and agents from any and all claims, liability, loss or expense (including reasonable attorney fees) for injuries or damage to any person and/or any property which arise out of the terms and conditions of this Agreement and the negligent or intentional acts or omissions of SMFD, its officers, employees, or agents. B. Severabilitv, If any term, condition, or provision of this Agreement is held by a court of competent jurisdiction to be invalid, void, or unenforceable, the remaining provisions will nevertheless continue in full force and effect, and shall not be affected, impaired or invalidated in any way. Notwithstanding the previous sentence, if a decision by a court of competent jurisdiction invalidates, voids, or renders unenforceable a term, condition, or provision in this Agreement that is included in the purpose of this Agreement then the parties to this Agreement shall either amend this Agreement pursuant to Section 8, or it shall be terminated. 1) Upon written notice, DMCS agrees to provide to SMFD, or any federal or State department having monitoring or reviewing authority, access to and the right to examine and audit its applicable records and documents for compliance with relevant federal and State statutes, rules and regulations, and this Agreement. 2) DHCS shall maintain and preserve all records relating to this Agreement for a period of three (3) years from receipt of the last payment of federal financial participation (FFP) or until audit findings are resolved, whichever is greater. )I[bnce able Law�All services to be performed by DHCS pursu a to this Agreement shall be performed in accordance with all applicable federal ani* State laws, including, but not limited to: 1) The Americans with Disabilities Act of 1990, as amended; 2) Section 504 of the Rehabilitation Act of 1973, as amende 3) Title 42, United States Code (U.S.C,) § 1396 et seq.; 4) Welfare and Institutions Code (W&I), § 14000 et seq; DHCS #16-93420 5) Government Code § 53060; 6) The California Medicaid State Plan; 7) Laws and regulations including, but not limited to licensure, certification, confidentiality of records, quality assurance, and nondiscrimination. E, Controlling law. The validity of this Agreement and its terms or provisions as we as the rights and duties of the parties hereunder, the interpretation an performance of this Agreement shall be governed by the laws of the State California, F� Iftotothtt glau§e. Notwithstanding the GEMT supplemental reimbursement program Provider Participation Agreement in Section G, listed below and the DHCS Form 6208 signed by SMFD, this Agreement and any exhibits attached hereto shall constitute the entire agreement among the parties to it and supersedes any prior or contemporaneous understanding or agreement with respect to the services contemplated. G, Proytd�er'�,Ja�th Agreement. This Agreement does not alter, amencl� or override any of the eligible provider's obligations and SMFID's obligations contained in the Provider Participation Agreement. The Provider Participation Agreement is an agreement between DHCS and each of the eligible providers, including SMFD in its capacity as an eligible provider. The Provider Participation Agreement provides the terms and conditions for the eligible providers to participate in the supplemental payment program. Such terms and conditions include, but are not limited to, (i) the requirement that the eligible providers reimburse SMFD for their share of the administrative costs incurred by DHCS in administering the supplemental payment program authorized in section 14105.94, subdivision (d), and (ii) the term that DHCS shall immediately and automatically without prior notice cease making supplemental payments and initiate a recovery effort against an eligible provider that fails to pay its administrative costs pursuant to the terms of the Provider Participation Agreement. H. Periodic Assessment. Pursuant to 14105.94, subdivision (d), 3MFD enters into this Agreement in order to implement the GEMT supplemental reimbursement program under which its eligible facilities may participate and for which SMFID will pay for the nonfederal share of all federally reimbursable administrative costs incurred by DHCS performing activities described in Section 7, SFMD agrees that DHCS may conduct a periodic assessment, as determined by DHCS, of such costs incurred by DHCS to determine compliance with Welfare and Institutions Code section 14105,94, subdivision (d)� and further agrees that all invoicing as described in Section 6 and any other relevant documentation will be accordingly updated to ensure compliance with Welfare and Institutions Code section 1410 5.94, subdivision (d). L Cdnfbrfftadb6 Glbu$e. This Agreement is entered in accordance with Welfare and Institutions Code section 1410 5.94, subdivision (d). Any provision of this Agreement in conflict with the present or future governing authorities of the Welfare and Institutions Code or other applicable state law or federal law and rules, including but not limited to, Title XIX of the Social Security Act, California's Medicaid State Plan, implementation directives promulgated by DHCS, and implementation directives promulgated by the Centers for Medicare & Medicaid DHCS #16-93420 Services, is hereby amended to conform to those authorities. Such amended provisions supersede any conflicting provision in this Agreement. The persons signing this Agreement on behalf of SMFD and DHCS, as applicable,, represent and warrant that he or she is an individual duly authorized and having authority to sign on behalf of, and approve for, SMFD or DHCS, as applicable, and is authorized and designated to enter into and approve this Agreement on behalf of SMFD or DHCS, as applicable. SACRAMENTO METROP ITAN FIRE DISTRICT Signature: Name: Todd Harms Title: Fire Chief Date: 4211 66-41 lh-c' C, SACRAMENTO MET OPOLITAN FIRE DISTRICT Signature: Name: Amanda Thomas Title: Chief Financial Officer Date: CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES Contract Management Unit Signature: Name: Title: UUTV'R'adtUWrr'0V0-0n �Mc �anaqemi-nl Unit Date: I =77 CALIFORNIA DEPARTMENT OF GENERAL SERVICES Office of Legal Services Signature: Name: Title: Date: CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES JULY 1, 2017 - JUNE 30, 2020 A. Lead the development, implementation, and administration for the Medi -Cal Ground Emergency Medical Transportation Services (GEMT) supplemental reimbursement program and ensure compliance with provision set forth in SPA 09-024. B. Submit claims for federal financial participation (FFP) based on expenditures for GEMT services that are allowable expenditures under federal law. C� On an annual basis, submit any necessary materials to the federal government to provide assurances that claims for FFP will include only those expenditures that are allowable under federal law. D, Reconcile certified public expenditure (CPE) invoices with supplemental reimbursement payments and ensure that the total Medi -Cal reimbursement provided to eligible GEMT providers will not exceed applicable federal upper payment limit as described in 42 C.F.R. 447 -Payments For Services. E Complete the audit and settlement process of the interim reconciliations for the claiming period within three years of the postmark date Of the cost report and conduct on-site audits as necessary. FCalculate the actual costs for administrative accountingi policy development� and data processing maintenance activities, including the indirect costs related to the GEMT supplemental reimbursement program provided by its staff based upon a cost accounting system which is in accordance with the provisions of Office of Management and Budget Circular A-87 and 45 Code of Federal Regulations Parts 74 and 95. Maintain accounting records to a level of detail which identifies the actual expenditures incurred for personnel services which includes salary/wages, benefits, travel and overhead costs for DHCS' staff, as well as equipment and all related operating expenses applicable to these positions to include, but not limited to, general expense, rent and supplies, and travel cost for identified staff and managerial staff working specifically on activities or assignments directly related to the GEMT supplemental reimbursement program, Accounting records shall include continuous time logs for identified staff that record time spent in the following areas: the GEMT supplemental reimbursement program, general administration. H. Ensure that an appropriate audit trail exists within DHCS records and accounting system and maintain expenditure data as indicated in this Agreement, 1. Desimate a Person to act as liaison with SMFD in regard to issues concernincl this Agreement. This person shall be identified to SMFD's contact person for this Agreement, J. Provide a written response by email or mail to SMFD's cont.- ct person within thirty (30) days of receiving a written request for information elated to the GEMT supplemental reimbursement program K. Provide accounting, and program technical assistance, and training related to the GEMT supplemental reimbursement program to SMFD personnel after receg a written request from SMFD contact person.